IFPTI Fellowship Cohort V: Research Presentation

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1 ifpti.org IFPTI Fellowship Cohort VI: IFPTI Fellowship Cohort V: Research Presentation Research Presentation Renita Stroupe, REHS Priya Nair

2 Behavior-Centric Risk Factor Control Between Two Management Groups Renita Stroupe, REHS IFPTI Fellow DeKalb County Board of Health, Georgia Funding for this program was made possible, in part, by the Food and Drug Administration through grant 1U18FD ; views expressed in written materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does any mention of trade names, commercial practices, or organization imply endorsement by the United States Government. Slide 2

The CDC has identified the top five risk factors that are typically

3 Background Restaurants are associated with a significant number of foodborne illness outbreaks (Cates, et al., 2006). The CDC has identified the top five risk factors that are typically responsible for foodborne illness outbreaks. Image source: nacchovoice.files.wordpress.com Slide 3

Background (continued) To educate industry and maintain an acceptable level of food safety standards at retail establishments, many states have adopted

4 Background (continued) To educate industry and maintain an acceptable level of food safety standards at retail establishments, many states have adopted regulations requiring a Certified Food Protection Manager (CFPM). FDA has found that the requirement is improving the overall practices within industry. Slide 4

5 Data from a 2008 study indicated improvement in 4 CDC risk factor categories (excluding proper cooking) when a Food Protection Manager certification was in compliance: Employee Health (including personal health and hygiene) Protection from contamination (including contaminated equipment) Approved source Background (continued) Holding temperatures of time/temperature control for safety Foods Slide 5

6 Background (continued) Latest FDA retail food study still indicates problems in reducing incidents of risk factor violations, even with CFPM (FDA, 2016). Little data is available to assess Food Protection Manager s implementation of food safety management system to control behavior in order to reduce risk factors. Slide 6

7 Background (continued) Are managers, achieving active managerial control to reduce employee behavior-centric risk factors within DeKalb County? Image source: DeKalbCounty.gov Image source: By David Benbennick [Public domain], via Wikimedia Commons Slide 7

health/hygiene and contaminated equipment/protection from contamination within DeKalb County, is

8 Problem Statement The degree to which employing a CFPM in comparison to utilizing a food safety management system to reduce incidents of two behavior-centric risk factor violations, poor personal health/hygiene and contaminated equipment/protection from contamination within DeKalb County, is unknown. Image source: Oilerstateinpatientacute.wikispaces.com (Creative Commons license) Image source Slide 8

9 Research Questions 1. Is there a relationship between the requirement of employing a CFPM and controlling foodborne illness risk factors, specifically personal health/hygiene and protection from contamination/contaminated equipment? 2. Does utilizing a food safety management system make a difference in behavior, specifically personal hygiene practices and protection from contamination? Slide 9

10 Methodology Data analysis of facilities within DeKalb County, GA Assessment of the Food Safety Management System used the FDA retail food program Foodborne Illness Risk Factor Study Protocol Data was collected using the FDA Retail Food Program Illness Risk Factor Study Protocol and Data Collection Form Slide 10

11 Certified Food Protection Manager (CFPM) ANSI-CFP accredited program Employed over 90 days Methodology (continued) Occurrence of Two Risk Factor Violations Occurrence of behavior-centric risk factor violations observed during unannounced investigations Collected information using FDA guidelines for data collection: Two Risks: Personal health and hygiene, contamination Four components: Personal health, personal hygiene, contaminated equipment, and protection from contamination Slide 11

12 Methodology Assessment of Management System utilizing FDA guidelines Three areas assessed: Procedures Training Monitoring Slide 12

13 Study chose randomly selected establishments using random number generator and Geographic Information System (GIS) mapping of permitted facilities within DeKalb County that have been open for at least 2 years Study examined 1.2% (26 establishments) of permitted retail food service establishments in DeKalb County, GA, comprised of: Healthcare facilities Restaurants (full-service and fast food) Schools Study Population Slide 13

14 3 of the 26 facilities were removed for lack of proof of CFPM or failure to employ CFPM Results 19 of the 23 remaining facilities have CFPM 6 of the 23 facilities have additional hazard analysis critical control points (HACCP) and standard operating procedures (SOPs) to ensure food protection in addition to the requirement for CFPM Slide 14

15 Results (continued) 40% 35% Observed Risk Factor Violations Health and Hygiene Contamination 36% 30% 25% 20% 15% 17% 25% 19% 29% 29% 24% 23% 10% 5% 0% Employee Health Employee Hygiene Contaminated Equipment CFPM Three Management All Facilities Groups Protection From Contamination Slide 15

16 Foodborne Illness Risk Factor Summary of Risk Factors Individual Data Items Poor Personal Hygiene/Health Proper Handwashing Prevent Contamination from Hands Handwashing convenient/accessible Good hygienic practices Restriction and exclusion practices Proper eating, drinking, or tobacco Contaminated Equipment/ Protection from Contamination Results (continued) Cleaned and sanitized food contact surfaces Raw animal foods separated from ready-to-eat foods Protection from environmental contamination Slide 16

17 Results (continued) OBSERVED RISK FACTOR VIOLATIONS Employee Hygiene Contaminated Equipment Employee Health Protection From contamination 42% 31% 31% 27% CFPM 12% 8% 4% 4% CFPM WITH SYSTEM Slide 17

18 Certified Food Protection Manager Results (continued) VIOLATIONS OBSERVED MANAGEMENT SYSTEM VS. NO MANAGEMENT SYSTEM No Management System Management System 33.3% 23.0% 14.3% 17.0% 66.7% 77.0% 85.7% 83.3% Employee Health Employee Hygiene Protection from Contamination Contaminated Equipment Slide 18

19 Observed Violations within FSMS Facilities Results (continued) Observed Personal Hygiene Risk Factor Management System Personal hygiene monitoring Personal hygiene training Personal hygiene procedures Observed Poor Personal hygiene Yes No Slide 19

20 CFPM has an impact: Conclusions Reduced incidence of violations compared to overall incidence found in facilities Facilities with additional measures appear to have better control of 2 observed risk factors during assessment Slide 20

21 More than just a certificate: Conclusions (continued) Other management systems need to be in place for control of other risk factors, especially contamination control Additional written and enforced procedures seem to have an impact on employee behavior Monitoring of behavior is crucial in altering of behavior. Slide 21

22 1. A CFPM should be on duty at all times. 2. The CFPM should utilize their knowledge to create written SOPs to address risk factors in the establishment. 3. The written procedures should include: Routine monitoring In-depth training Standard procedure Recommendations Slide 22

23 Jennifer Kirby, Department Manager, DeKalb County Board of Health, GA International Food Protection Training Institute (IFPTI): Charlene Bruce, Mentor Dr. Paul Dezendorf, Research Subject Matter Expert IFPTI Staff and Fellows Acknowledgements Slide 23

24 Questions? Renita Stroupe, REHS (404) Slide 24

26 Additional Supporting Information Table of Contents Data Collection Questions FDA Retail Food Service Data Collection Form Observed Protection from Contamination Risk Factor Management System Risk Factor Violations When PIC Is CFPM Observed Personal Hygiene Risk Factor Slide 26

ifpti.org Research Presentation

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